<!--<div id="content">-->
<div class="container">
	<div class="row">
		<div class="col-sm-8">
			<a class="navbar-brand navbar-title" href="#">End User Register</a>
		</div>
	</div>
	<div class="row">
		<div class="col-sm-8">
			<div id="message"></div>
                <?php echo form_open("end_user/registration_view"); ?>
        	<div class="contact-form">
				<div class="row">
					<div class="col-sm-6">
						<input name="name" type="text" id="name" value="<?php echo set_value('name'); ?>"
						class="form-control contact-input" placeholder="Name">
						<?php echo form_error('name', '<div class="error">', '</div>'); ?>
              		</div>
				</div>
				<div class="row">
					<div class="col-sm-6">
						<input name="email" type="text" id="email" class="form-control contact-input animate" 
						placeholder="Email" value="<?php echo set_value('email'); ?>" />
						<?php echo form_error('email', '<div class="error">', '</div>'); ?>
                	</div>
				</div>
				<div class="row">
					<div class="col-sm-12">
						<label>Tel Number</label> 
							<input name="tel_number1" size="4" class="numeric  contact-input animate" type="text" 
							maxlength="4" value="<?php echo set_value('tel_number1'); ?>" />- 
							<input name="tel_number2" size="4" class="numeric  contact-input animate" type="text" 
							maxlength="4" value="<?php echo set_value('tel_number2'); ?>" />- 
							<input name="tel_number3" size="4" class="numeric  contact-input animate" type="text" 
							maxlength="4" value="<?php echo set_value('tel_number3'); ?>" />
							<?php echo form_error('tel_number1', '<div class="error">', '</div>'); ?>
							<?php echo form_error('tel_number2', '<div class="error">', '</div>'); ?>
							<?php echo form_error('tel_number3', '<div class="error">', '</div>'); ?>
                 	</div>
				</div>
				<div class="row">
					<div class="col-sm-12">
						<label>Fax Number</label> 
							<input name="fax1" size="4" class="numeric  contact-input animate" type="text" maxlength="4"
							value="<?php echo set_value('fax1'); ?>" />- 
							<input name="fax2" size="4" class="numeric  contact-input animate" type="text" maxlength="4" 
							value="<?php echo set_value('fax2'); ?>" />- 
							<input name="fax3" size="4" class="numeric  contact-input animate" type="text" maxlength="4"
							value="<?php echo set_value('fax3'); ?>" />
         					<?php echo form_error('fax1', '<div class="error">', '</div>'); ?>
         					<?php echo form_error('fax2', '<div class="error">', '</div>'); ?>
         					<?php echo form_error('fax3', '<div class="error">', '</div>'); ?>
                	</div>
				</div>
				<div class="row">
					<div class="col-sm-12">
						<span class="pro"> <label>Province :</label> 
							<?php echo form_dropdown ( "province", $option_province, "", "id='pro_id_user'" ); ?>
						</span>
							<?php echo form_error('province', '<div class="error">', '</div>'); ?>
							<span class="dis"> <label>District :</label>
							    <?php echo form_dropdown ( "district", 
							    	array ('--- SELECT DISTRICT ---' => '--- SELECT DISTRICT ---'), '', 'disabled', "id='dis_id'" );
								?>
							</span>
								<?php echo form_error('district', '<div class="error">', '</div>'); ?>
					</div>
				</div>
				<div class="row">
					<div class="col-sm-12">
						<textarea id="address" rows="10" placeholder="Address" class="form-control contact-textarea" 
						name="address"><?php echo set_value('address'); ?></textarea>
						<?php echo form_error('address', '<div class="error">', '</div>'); ?>
	  				 </div>
				</div>
				<div class="row">
					<div class="col-sm-6">
						<input type="text" class="form-control contact-input date" id="meet_date" name="meet_date"
						value="<?php echo set_value('meet_date'); ?>" placeholder="Meet Date">
		  				 <?php echo form_error('meet_date', '<div class="error">', '</div>'); ?>
	  				</div>
				</div>
				<div class="row">
					<div class="col-sm-12">
						<div class="pull-left clearfix">
							<button type="button" id="submit" class="submit-btn active-btn" onclick="history.go(-1);">Back</button>
						</div>
						<div class="pull-right clearfix">
							<button type="submit" id="submit" class="submit-btn active-btn">Next</button>
						</div>
					</div>
				</div>
			</div>
                 <?php echo form_close(); ?>
            </div>
		<div class="col-sm-4"></div>
	</div>
</div>
